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Where the young dont want to live

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SUICIDES IN INDIA

Where the young dont want to live

The findings of a 2012 Lancet study on death by suicide in India reveal the alarming trend of suicide among those under the age of 29. Comparing theLancet figures with NCRB data, Shambhu Ghatak highlights the real extent of the problem and identifies some of the key causes.

19 July 2013 -

Media reports about Jiah Khan's suicide on 3 June, 2013, shocked the entire nation including her fans. People were saddened to see such a young talent, just 25 years of age and involved romantically with another aspiring Bollywood starlet, ending her life so soon. On her untimely demise, a superstar remarked that life should be respected more than love. Clearly, Jiah Khan's tragic death drew much of both media and people's attention since she was a rising star on the silver screen. But several recent studies indicate that suicides in general are quite common, particularly among the youth.

According to the official source Accidental Deaths and Suicides in India (ADSI) 2012,suicide means deliberate termination of life. The essential ingredients of a suicide identified herein are:

It should be an unnatural death;

The desire to die should originate within him/her (thus, distinguishing suicide from abetment of suicide, which is a crime under Section 306 of Indian Penal Code-IPC);

There should be a reason for ending life

A background

A recent Lancet study titled Suicide mortality in India: A nationally representative survey(2012) estimated about 186900 suicide deaths in India in 2010 at ages 15 years and above (114800 men and 72100 women). The study found that 40 per cent among the men (45100 of 114800) and 56 per cent among women (40500 of 72100) who committed suicide in 2010 were aged 15-29 years. The age-standardised suicide rate found in Indian women aged 15 years or older (17.5 per 1 lakh population) is more than two and a half times higher than in women of the same age in high-income countries (6.8 per 1 lakh population) and nearly as high as it is in China.

Throwing light on the Lancet study, Vikram Patel in an op-ed published in The Hindu(dated 22 June, 2012) informs that suicide is the second leading cause of death among the youth, both male and female. Apart from their risk-taking and impulsive character, social and interpersonal factors such as violence and disappointments in relationships coupled with mental health factors, notably depression, and substance abuse made young people especially vulnerable to suicides.

Mental maladies, most notably depression, is one of the key factors behind the high rate of suicide among youth. Pic: Andrew Mason/Wikimedia

Explaining the paradox of higher suicide rates among young people from the developed and educated southern states, which otherwise have a sound track record in human development, Patel reasons that in a rapidly changing society that brings before the young generation newer challenges by redefining the meanings of success and prosperity, the youth get easily disappointed when aspirations are not fulfilled, leaving them alone in the midst of high competition. High-paying jobs are often not secured enough for the youths to prevent them from crossing the barrier between life and death.

Most suicide deaths took place in rural areas because of the higher availability of pesticides combined with poorer access to emergency medical care in such areas. Indians prefer to consume pesticides for killing themselves instead of taking an overdose of sleeping pills. Therefore, the fatality rates may be higher in India as compared to the western countries. Nearly, 49 percent suicide deaths in men and 44 per cent suicide deaths in women aged 15 years and above occurred due to poisoning, mostly from consuming pesticides.

The Lancet study (2012) found that hanging was the second most common method in both men (35 per cent) and women (26 per cent); burns were a common method in women, accounting for 15 per cent of suicide deaths in them. Roughly, three-fifths of suicide deaths took place at home. Men who indulged in drinking alcohol and engaged in agricultural work were at a greater risk to commit suicide.

NCRB data on suicides

According to NCRB data, nearly 34 persons out of 100 who ended their own lives fell in the age-group 15-29 years. The total number of suicides in the age group 15-29 years increased from 38,910 in 2001 to 46,635 in 2012, demonstrating a jump of 19.9 per cent.

One can also form a picture of the trends related to suicides committed in India by gleaning data from Ministry of Statistics and Programme Implementation's (MoSPI) report entitled Statistical Year Book of India 2013. The report collected and presented suicide data from NCRB’s ADSI (various issues), which is produced annually. The recently released ADSI 2012is also consulted.

Age and gender profiles of suicide victims

According to NCRB data, nearly 34 persons out of 100 who ended their own lives fell in the age-group 15-29 years. Coming close to this youth group in terms of number of suicides were persons who belonged to the age-group 30-44 years. The total number of suicides in the age group 15-29 years increased from 38910 in 2001 to 46635 in 2012, demonstrating a jump of 19.9 per cent. The total number of suicides in the age-group 30-44 years increased even more by 26.6 per cent from 36448 in 2001 to 46160 in 2012.

Out of 100 persons, who commit suicide and die, roughly 65 are male and 35 are female. The total number of men who committed suicide increased from 66314 in 2001 to 88453 in 2012, displaying a jump of 33.4 per cent in 11 years. The total number of female suicides increased by 11.4 per cent from 42192 in 2001 to 46992 in 2012.

Table 1: Suicide victims by sex & age-group during 2012

MALE

FEMALE

Upto 14 years

1353

1385

15-29 year

25942

20693

30-44 year

31704

14456

45-59 year

21217

7282

60 year and above

8237

3176

Total (15 years and above)

87100

45607

As per the NCRB data for 2012, 29.8 per cent among men (i.e. 25942 of 87100) and 45.4 per cent among women (20693 of 45607) who committed suicide were aged 15-29 years(see table 1). This clearly stands in significant variance with the Lancet study (2012) that found 40 per cent among male suicides and 56 per cent of female suicides in 2010 falling in that same age-group.

A reason to die for

The ADSI 2012 provided 22 different causes behind suicides. Family problems (25.6 per cent) and illness (20.8 per cent) accounted for 46.4 per cent of total suicides in India during 2012. Insanity/mental illness accounted for 6.4 per cent of total suicide deaths. On average, the country witnessed 69 suicides per day due to illness, 11 suicides per day owing to love affairs, 6 suicides per day due to poverty, 6 suicides per day due to failure in examination, 5 suicides per day owing to unemployment and 5 suicides per day due to dowry dispute.

According to Patel (2013), it is estimated that nearly 50 million people living in India are affected by mental health conditions. Such conditions cause profound suffering for the affected individuals and their families. Mental maladies are associated with poor physical health and with mortality, most notably through suicide.

Methods adopted for committing suicides

The Lancet study (2012) detected that about half of suicide deaths were due to poisoning (mainly ingestion of pesticides). However, the ADSI 2012 disclosed that in 37 per cent of suicide death cases during 2012, hanging was the predominant method chosen; poisoning by consumption of insecticides (29.5 percent) came next.

The other methods adopted across all ages and gender are: fire/ self-immolation (8.4 per cent), drowning (5.8 per cent), coming under running vehicles/ train (3.1 per cent) etc.

Battle of data: Lancet versus NCRB

Both religious and social pressures cause underreporting of suicides. The Lancet study (2012) found that the official source of data on suicide  National Crime Records Bureau (NCRB) -- reported fewer suicide deaths (134599) in 2010 as compared to its own estimate of 186900 suicide deaths in India at ages 15 years and above. Questioning the reliability of NCRB data, the Lancet study elaborated that the official source of data in India is based on police reports and suicide is considered a crime in India, which affects the veracity of reporting.

The scathing report from Lancet put paid to NCRB’s suicide underestimates. By comparing the data from the Lancet study (2012), it was found that the NCRB underestimated suicide deaths in men by at least 25 per cent and women by at least 36 per cent, with many of the under-reported suicide deaths occurring among women and men aged 1529 years and among women aged 60 years or older.

The allegation against NCRB data is not new. A study entitled Every Thirty Minutes-Farmer Suicides, Human Rights, and the Agrarian Crisis in India (2011) by the Centre for Human Rights and Global Justice (CHRGJ) found that farmers belonging to subordinate castes and their families face discriminatory policies when it comes to land entitlement. Farmers who do not have title to land are not enumerated as the same in official surveys and therefore when the family head dies by committing suicide, the family is often deprived of the compensation and relief package, which is offered by the government. Similarly, tenant farmers who leased in land are not counted as farmers. This reflects in under-reportage of such suicides in official data.

Preventive measures and roadblocks

The Lancet study observes that suicide is an important cause of avoidable deaths in India, especially in young adults. India needs to regulate access to lethal methods such as pesticides. The country is required to rein in violence experienced by young people, impart life skills to them and promote mental health in schools and colleges. Vikram Patel (2012) argues for improving access to treatment for depression and counselling for those who survive a first suicide attempt.

Clearly, the country is yet to come to grips with this upsetting trend of suicide among youth. Despite clinics opening cities to address mental health issues like depression, there is a stigma associated with psychiatric treatment. People suffering from mental health conditions hide their illness to avoid discrimination.

Patel also points out that India is facing an acute shortage of mental healthcare resources. The country has only about 4000 psychiatrists (and even fewer of other specialized mental health professionals) for its 1.2 billion people. Out of the 30,000 in-patient beds, a majority is situated in colonial-era mental hospitals, where patients are known to undergo custodial care and human rights abuse. Only 1 per cent of the national health budget is earmarked for mental health, thus, indicating the apathy of the government towards addressing mental health issues. Sunk in a quagmire, the District Mental Health Programme (DMHP), which is operating in 123 districts, is in dire need of revamp.

Under the new Mental Health Care Bill 2012, an attempt is being made by the Union Health Ministry to decriminalize the act of suicide for persons suffering from mental illness. The draft Mental Health Care Bill proposes a series of progressive clauses, including a provision that persons who attempt suicide will now have the right to confidentiality of mental healthcare information. Under the new bill, the state is required to take responsibility for the implementation of programmes for promotion of mental health and prevention of mental illness and suicide. The state is also expected to ensure that adequate numbers of mental health professionals are available.

Attempting suicide is currently an offence under Section 309 of the Indian Penal Code that can attract punishment of up to one year in jail and a fine. Many experts reckon that making suicide ‘illegal’ has actually proved counterproductive. In the past, criminalisation of suicide has been found to stop people from seeking proper treatment even after a suicide is attempted. It has also made it more difficult to locate the economic, social or medical reasons behind a suicide. With more studies such as these and the discussions they inspire, and the passage of the new Mental Health Care Bill, one hopes that the country will find a way to check the unfortunate incidence of young lives prematurely ended.

Shambhu Ghatak19 July 2013

Shambhu Ghatak is a researcher on developmental issues like hunger, food security and employment.